食管癌的新辅助治疗。

Neoadjuvant Therapy in Esophageal Cancer.

机构信息

Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada; Department of Radiotherapy and Oncology, Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.

Department of Radiation Oncology, University of Toronto, Toronto, Canada.

出版信息

Thorac Surg Clin. 2022 Nov;32(4):447-456. doi: 10.1016/j.thorsurg.2022.06.003.

DOI:10.1016/j.thorsurg.2022.06.003

PMID:36266032

Abstract

Locally advanced esophageal cancer has a dismal prognosis. Surgery remains the cornerstone treatment with 5-year survival rates of approximately 12-39%. Rates of local failure and distant metastases are high following surgical resection of locally advanced tumors. Neoadjuvant therapy (either radiation therapy, chemotherapy, or a combination) prior to surgery carries the advantage of tackling micrometastases and improving complete resection rates. Neoadjuvant concurrent chemotherapy and radiotherapy are a favored approach with evidence for improved pathologic complete response (pCR) rates and improved survival compared with surgery alone. Randomized trials of the optimal neoadjuvant approach are ongoing.

摘要

局部晚期食管癌预后不良。手术仍然是基石治疗方法，5 年生存率约为 12-39%。局部晚期肿瘤手术后局部复发和远处转移率较高。手术前进行新辅助治疗（放疗、化疗或联合治疗）具有解决微转移和提高完全切除率的优势。新辅助同期化疗和放疗是一种受青睐的方法，与单独手术相比，证据表明其病理完全缓解（pCR）率提高，生存获益改善。目前正在进行最佳新辅助方法的随机试验。